Increased Treatment Intensity Promotes Reduced Attrition in Parent Training Programs for Children With Challenging Behavior

Background Behavioral Parent Training (BPT) Programs are highly efficacious but are limited due to high attrition. We sought to reduce attrition through modifications to the intensity level (i.e., number of hours per week) with which services are delivered. Methods We conducted a nonrandomized, parametric study of three distinct treatment intensity levels (high, medium, and low) with 116 participants with clinically significant challenging behavior and their caregivers. We examined rates of attrition, within appointment behavior reduction, and pre-post changes in standardized measures across all treatment groups. Results Rates of attrition varied by intensity level, with higher intensities producing less dropout (i.e., 6% in high intensity vs. 36% in low intensity). Statistically significant reductions in pre-post measures with large effects sizes were found in both the high and moderate intensity levels ( d ’s = 0.95–1.2 and 0.56–1.0, respectively). Conclusions Optimizing behavioral service delivery can address limitations in current BPT programs and may have substantial public policy implications.